Citation Nr: 9826126
Decision Date: 08/31/98 Archive Date: 07/27/01
DOCKET NO. 97-05 985 ) DATE
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On appeal from the
Department of Veterans Affairs Regional Office in Detroit,
Michigan
THE ISSUE
Entitlement to service connection for an infection about the
rectum and perineum as secondary to the veteran's service-
connected urinary incontinence.
REPRESENTATION
Appellant represented by: The American Legion
ATTORNEY FOR THE BOARD
R. A. Caffery, Counsel
INTRODUCTION
The veteran served on active duty from November 1945 to
October 1947. This is an appeal from an October 1996 rating
action by the Department of Veterans Affairs (VA) Regional
Office, Detroit, Michigan, which denied entitlement to
service connection for an infection about the rectum and
perineum as secondary to the veteran's service-connected
urinary incontinence.
REMAND
The record discloses that, in January 1992, the veteran
underwent a radical prostatectomy for prostate cancer at a VA
medical center. He thereafter had urinary incontinence.
In a March 1996 rating action, the regional office granted VA
disability compensation for urinary incontinence under the
provisions of 38 U.S.C.A. § 1151 as though that condition
were service connected. The condition was rated 60 percent
disabling.
When the veteran was examined by the VA in April 1996, it was
indicated that he had used Depends because of his urinary
incontinence. It was stated that, in March 1995, he had been
treated with antibiotics for an unrelated condition and had
developed a severe yeast infection about the rectum and
perineum.
On examination there was no rash about the groin or buttocks
incident to the old yeast infection. The rectal examination
was entirely normal. A urinalysis was negative and a
complete blood count was unremarkable. The impressions
included incontinence secondary to carcinoma of the prostate.
VA outpatient treatment records were later received by the
regional office reflecting that, when the veteran was seen in
May 1995, it was indicated that he had a rash on his
buttocks. In August 1995, a rash on his groin was reported.
In September 1995, it was indicated that the yeast infection
had cleared with medication. When he was seen in December
1995, it was indicated that the yeast infection recurred
periodically. Later in December 1995, his complete blood
count was reported to be within normal limits and a
urinalysis was negative. When he was seen in September 1996,
it was indicated that he still had itching in the groin area.
The assessments included atopic dermatitis and urinary
incontinence.
The veteran has maintained that the use of Depends which is
necessitated by his urinary incontinence is in fact the
reason his infection cannot be controlled and that the
aggressive use of antibiotics has exacerbated the condition
to the point where he is still in need of treatment in order
to avoid a constant infectious state. In essence, the record
is unclear as to whether the veteran has an additional
chronic disability related to his incontinence.
The Board believes that the veteran has submitted a well-
grounded claim; that is, a claim which is plausible.
Accordingly, the VA has a duty to assist him in the
development of his claim. 38 U.S.C.A. § 5107(a).
On the basis of the present record, the Board believes that
additional information would be desirable and the case is
accordingly REMANDED for the following action:
1. The VA Medical Center in Saginaw
should be contacted and asked to provide
copies of any outpatient treatment
records of the veteran at that facility
subsequent to December 1996. Any such
records obtained should be associated
with the claims file.
2. The veteran should then be afforded
appropriate examinations in order to
determine the current nature and extent
of any yeast infection or rash that may
now be present. All indicated special
studies should be conducted. The
examiners should express opinions as to
whether any yeast infection or rash has
been caused by the veteran's urinary
incontinence resulting from his
prostatectomy and whether any such
infection or rash represents a chronic
condition.
3. The veteran's claim should then be
reviewed by the regional office. If the
denial is continued, he and his
representative should be sent a
supplemental statement of the case and be
afforded the appropriate time in which to
respond. No action is required of the
veteran until he receives further notice.
The purpose of this remand is to obtain clarifying
information. The Board intimates no opinion as to the
disposition warranted in this case pending completion of the
requested action.
ROBERT D. PHILIPP
Member, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1996).